const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Hypolipidemic Drugs - MBBS 2nd Prof";
pres.author = "Orris Medical Education";

// ─── COLOR PALETTE ───────────────────────────────────────────────
// Deep navy dominant, teal accent, white text, amber highlight
const NAVY   = "0D2B55";   // dominant dark background
const TEAL   = "1A7B8C";   // section header accent
const LTBLUE = "D6EAF8";   // light panel background
const WHITE  = "FFFFFF";
const AMBER  = "F0A500";   // highlight / callout
const GRAY   = "4A5568";   // body text on light bg
const LBLUE2 = "EAF4FB";   // alternate row fill

// ─── HELPER FUNCTIONS ────────────────────────────────────────────
function addSlideHeader(slide, title, subtitle) {
  // Top colored bar
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: 0.72, fill: { color: NAVY } });
  // Amber accent line
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0.72, w: "100%", h: 0.06, fill: { color: AMBER } });
  // Title
  slide.addText(title, {
    x: 0.35, y: 0.05, w: 9.3, h: 0.62,
    fontSize: 22, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle", margin: 0
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.35, y: 0.78, w: 9.3, h: 0.28,
      fontSize: 11, italic: true, color: TEAL, fontFace: "Calibri", valign: "middle", margin: 0
    });
  }
}

function addFooter(slide, pageNum) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.4, w: "100%", h: 0.23, fill: { color: NAVY } });
  slide.addText("Hypolipidemic Drugs  |  MBBS 2nd Prof Pharmacology", {
    x: 0.3, y: 5.4, w: 7.5, h: 0.23, fontSize: 8, color: "A0AEC0", fontFace: "Calibri", valign: "middle", margin: 0
  });
  slide.addText(`${pageNum} / 12`, {
    x: 9.0, y: 5.4, w: 0.8, h: 0.23, fontSize: 8, color: "A0AEC0", align: "right", fontFace: "Calibri", valign: "middle", margin: 0
  });
}

function bulletItems(items, color) {
  return items.map((txt, i) => ({
    text: txt,
    options: { bullet: { code: "2022" }, color: color || GRAY, fontSize: 14, fontFace: "Calibri",
               breakLine: i < items.length - 1 }
  }));
}

function subBulletItems(items, color) {
  return items.map((txt, i) => ({
    text: txt,
    options: { bullet: { code: "25B8" }, indentLevel: 1, color: color || "5A6E80",
               fontSize: 12, fontFace: "Calibri", breakLine: i < items.length - 1 }
  }));
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  // Full dark background
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: NAVY } });
  // Decorative teal band
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 2.5, w: "100%", h: 0.08, fill: { color: TEAL } });
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 2.62, w: "100%", h: 0.04, fill: { color: AMBER } });

  slide.addText("HYPOLIPIDEMIC DRUGS", {
    x: 0.5, y: 0.6, w: 9.0, h: 1.0, fontSize: 38, bold: true, color: WHITE,
    fontFace: "Calibri", align: "center", charSpacing: 3
  });
  slide.addText("Newer Agents & Treatment Strategies", {
    x: 0.5, y: 1.65, w: 9.0, h: 0.55, fontSize: 22, color: AMBER,
    fontFace: "Calibri", align: "center", italic: true
  });
  slide.addText("Pharmacology  |  MBBS 2nd Professional", {
    x: 0.5, y: 2.75, w: 9.0, h: 0.4, fontSize: 14, color: "A0C4D8",
    fontFace: "Calibri", align: "center"
  });
  // Decorative molecule-like circles
  slide.addShape(pres.ShapeType.ellipse, { x: 0.2, y: 4.3, w: 1.0, h: 1.0, fill: { color: TEAL }, line: { color: TEAL } });
  slide.addShape(pres.ShapeType.ellipse, { x: 8.8, y: 0.1, w: 0.7, h: 0.7, fill: { color: AMBER }, line: { color: AMBER } });
  slide.addShape(pres.ShapeType.ellipse, { x: 8.3, y: 4.5, w: 0.5, h: 0.5, fill: { color: "1A6B7C" }, line: { color: TEAL } });

  slide.addText("Source: Lippincott Illustrated Reviews Pharmacology, 8e  |  Goodman & Gilman's 14e", {
    x: 0.5, y: 5.1, w: 9.0, h: 0.3, fontSize: 9, color: "607D8B",
    fontFace: "Calibri", align: "center", italic: true
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW & CLASSIFICATION
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Overview & Classification of Hypolipidemic Drugs", "Dyslipidemia — a major risk factor for coronary heart disease (CHD)");

  const classes = [
    ["HMG-CoA Reductase Inhibitors", "Statins", TEAL],
    ["Cholesterol Absorption Inhibitor", "Ezetimibe", "1E8449"],
    ["Bile Acid Sequestrants", "Cholestyramine, Colestipol, Colesevelam", "7D3C98"],
    ["PCSK9 Inhibitors", "Alirocumab, Evolocumab (NEWER)", AMBER],
    ["ATP-Citrate Lyase Inhibitor", "Bempedoic Acid (NEWER)", "C0392B"],
    ["Fibrates", "Gemfibrozil, Fenofibrate", "1A5276"],
    ["Nicotinic Acid (Niacin)", "Triglyceride & LDL lowering", "6E2F8B"],
    ["Omega-3 Fatty Acids", "Icosapent ethyl (NEWER)", "1A7B8C"],
    ["MTP Inhibitor", "Lomitapide (for Homozygous FH)", "884EA0"],
  ];

  const cols = [0.25, 4.9];
  const rowH = 0.41;
  const startY = 1.1;

  classes.forEach(([cls, drug, color], i) => {
    const y = startY + i * rowH;
    const fill = i % 2 === 0 ? LBLUE2 : WHITE;
    slide.addShape(pres.ShapeType.rect, { x: cols[0], y, w: 4.5, h: rowH - 0.04, fill: { color: fill } });
    slide.addShape(pres.ShapeType.rect, { x: cols[1], y, w: 4.9, h: rowH - 0.04, fill: { color: fill } });
    slide.addText(cls, { x: cols[0] + 0.08, y: y + 0.03, w: 4.3, h: rowH - 0.1, fontSize: 11.5, color: color, bold: true, fontFace: "Calibri" });
    slide.addText(drug, { x: cols[1] + 0.08, y: y + 0.03, w: 4.7, h: rowH - 0.1, fontSize: 11, color: GRAY, fontFace: "Calibri" });
  });

  // column headers
  slide.addShape(pres.ShapeType.rect, { x: cols[0], y: startY - 0.3, w: 4.5, h: 0.28, fill: { color: TEAL } });
  slide.addShape(pres.ShapeType.rect, { x: cols[1], y: startY - 0.3, w: 4.9, h: 0.28, fill: { color: TEAL } });
  slide.addText("DRUG CLASS", { x: cols[0] + 0.08, y: startY - 0.3, w: 4.3, h: 0.28, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText("EXAMPLES", { x: cols[1] + 0.08, y: startY - 0.3, w: 4.7, h: 0.28, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });

  addFooter(slide, 2);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 3 — STATINS (HMG-CoA Reductase Inhibitors)
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Statins — HMG-CoA Reductase Inhibitors", "First-line drugs for hypercholesterolaemia");

  // Left column
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.55, h: 0.3, fill: { color: TEAL } });
  slide.addText("MECHANISM", { x: 0.3, y: 1.1, w: 4.4, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    { text: "Competitively inhibit HMG-CoA reductase", options: { bullet: { code: "2022" }, color: GRAY, fontSize: 12, fontFace: "Calibri", breakLine: true } },
    { text: "↓ Hepatic cholesterol synthesis → ↑ LDL-R expression", options: { bullet: { code: "25B8" }, indentLevel: 1, color: "5A6E80", fontSize: 11, fontFace: "Calibri", breakLine: true } },
    { text: "Net effect: ↓ LDL-C by 30–60%, ↓ TG, mild ↑ HDL", options: { bullet: { code: "25B8" }, indentLevel: 1, color: "5A6E80", fontSize: 11, fontFace: "Calibri", breakLine: false } },
  ], { x: 0.3, y: 1.42, w: 4.5, h: 0.9 });

  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 2.38, w: 4.55, h: 0.3, fill: { color: TEAL } });
  slide.addText("THERAPEUTIC USES", { x: 0.3, y: 2.38, w: 4.4, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "1° & 2° prevention of ASCVD",
      "Familial hypercholesterolaemia",
      "Diabetic dyslipidaemia",
      "Post-MI / stable angina / stroke prevention"
    ])
  ], { x: 0.3, y: 2.7, w: 4.5, h: 1.0 });

  // Right column
  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.65, h: 0.3, fill: { color: NAVY } });
  slide.addText("ADVERSE EFFECTS", { x: 5.15, y: 1.1, w: 4.5, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Myopathy / Rhabdomyolysis (rare, ↑ with fibrates)",
      "Raised hepatic transaminases",
      "GI: nausea, abdominal pain",
      "Teratogenic — CONTRAINDICATED in pregnancy",
      "New-onset diabetes (long-term use)"
    ])
  ], { x: 5.15, y: 1.42, w: 4.5, h: 1.2 });

  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 2.75, w: 4.65, h: 0.3, fill: { color: NAVY } });
  slide.addText("DRUGS & POTENCY", { x: 5.15, y: 2.75, w: 4.5, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  const statins = [["Rosuvastatin", "↓ LDL 55–65%"], ["Atorvastatin", "↓ LDL 40–60%"], ["Simvastatin", "↓ LDL 28–35%"], ["Pravastatin", "↓ LDL 22–34%"], ["Lovastatin", "↓ LDL 20–30%"]];
  statins.forEach(([name, effect], i) => {
    const y = 3.08 + i * 0.28;
    const fill = i % 2 === 0 ? LBLUE2 : WHITE;
    slide.addShape(pres.ShapeType.rect, { x: 5.1, y, w: 4.65, h: 0.27, fill: { color: fill } });
    slide.addText(name, { x: 5.15, y: y + 0.04, w: 2.8, h: 0.22, fontSize: 11, color: GRAY, fontFace: "Calibri" });
    slide.addText(effect, { x: 7.9, y: y + 0.04, w: 1.8, h: 0.22, fontSize: 11, color: "C0392B", bold: true, fontFace: "Calibri" });
  });

  addFooter(slide, 3);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 4 — EZETIMIBE & BILE ACID SEQUESTRANTS
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Ezetimibe & Bile Acid Sequestrants", "Adjuncts to statin therapy");

  // Ezetimibe
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.55, h: 0.32, fill: { color: "1E8449" } });
  slide.addText("EZETIMIBE (Cholesterol Absorption Inhibitor)", { x: 0.3, y: 1.1, w: 4.4, h: 0.32, fontSize: 11.5, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems(["Inhibits NPC1L1 transporter in intestinal brush border", "↓ Dietary & biliary cholesterol absorption by ~50%", "↓ LDL-C by 18–20%; can be combined with statins", "Used in: Statin intolerance, familial hypercholesterolaemia", "ADR: GI upset, myopathy (rare), hepatitis (rare)", "Avoid in hepatic impairment; safe in pregnancy (Cat B)"])
  ], { x: 0.3, y: 1.45, w: 4.5, h: 2.0 });

  // Bile acid sequestrants
  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.65, h: 0.32, fill: { color: "7D3C98" } });
  slide.addText("BILE ACID SEQUESTRANTS (Resins)", { x: 5.15, y: 1.1, w: 4.5, h: 0.32, fontSize: 11.5, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Drugs: Cholestyramine, Colestipol, Colesevelam",
      "Bind bile acids in gut → ↑ bile acid synthesis from cholesterol → ↑ LDL-R → ↓ LDL-C by 15–30%",
      "Used in: Hypercholesterolaemia, pruritus in biliary disease",
      "ADR: Constipation, bloating, steatorrhoea",
      "Drug interactions: Bind fat-soluble vitamins (A,D,E,K), warfarin, digoxin, thyroxine — give other drugs 1 hr before or 4 hrs after",
      "Colesevelam: Also approved for type-2 DM"
    ])
  ], { x: 5.15, y: 1.45, w: 4.5, h: 2.1 });

  // Combination note box
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.5, w: 9.5, h: 0.7, fill: { color: LTBLUE }, line: { color: TEAL, pt: 1.5 } });
  slide.addText([
    { text: "KEY POINT: ", options: { bold: true, color: TEAL, fontSize: 13, fontFace: "Calibri" } },
    { text: "Statin + Ezetimibe combination (e.g., Rosuvastatin + Ezetimibe) gives additive LDL lowering and is first-line combination before adding a PCSK9 inhibitor. The IMPROVE-IT trial confirmed CV benefit of adding ezetimibe to simvastatin.", options: { color: GRAY, fontSize: 12, fontFace: "Calibri" } },
  ], { x: 0.35, y: 4.52, w: 9.3, h: 0.65 });

  addFooter(slide, 4);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 5 — PCSK9 INHIBITORS (NEWER)
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "PCSK9 Inhibitors — A Landmark Newer Drug Class", "Monoclonal antibodies: Alirocumab (PRALUENT) & Evolocumab (REPATHA)");

  // Mechanism box
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 9.5, h: 0.95, fill: { color: LTBLUE }, line: { color: AMBER, pt: 2 } });
  slide.addText("MECHANISM", { x: 0.35, y: 1.12, w: 2.0, h: 0.25, fontSize: 12, bold: true, color: AMBER, fontFace: "Calibri" });
  slide.addText("PCSK9 (proprotein convertase subtilisin/kexin type 9) normally DEGRADES LDL receptors on hepatocytes. Alirocumab / Evolocumab are monoclonal antibodies (IgG) that BIND and INHIBIT PCSK9 → LDL-R recycling is preserved → ↑↑ LDL clearance from blood → ↓ LDL-C by ~55–60% on top of statin therapy.",
    { x: 0.35, y: 1.38, w: 9.3, h: 0.65, fontSize: 12, color: GRAY, fontFace: "Calibri" });

  // Two columns
  const leftX = 0.25, rightX = 5.1;
  slide.addShape(pres.ShapeType.rect, { x: leftX, y: 2.15, w: 4.55, h: 0.3, fill: { color: AMBER } });
  slide.addText("THERAPEUTIC USES", { x: leftX + 0.05, y: 2.15, w: 4.4, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Familial hypercholesterolaemia (homo- & heterozygous)",
      "High CV risk patients not at goal on max statin + ezetimibe",
      "Statin-intolerant patients",
      "Secondary prevention after MI/stroke",
      "Hyperlipidaemia with very high LDL-C (>190 mg/dL)"
    ])
  ], { x: leftX + 0.05, y: 2.47, w: 4.45, h: 1.65 });

  slide.addShape(pres.ShapeType.rect, { x: rightX, y: 2.15, w: 4.65, h: 0.3, fill: { color: AMBER } });
  slide.addText("KEY FEATURES & ADRs", { x: rightX + 0.05, y: 2.15, w: 4.5, h: 0.3, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Route: Subcutaneous injection every 2–4 weeks",
      "LDL reduction: 55–65% (profound effect)",
      "FOURIER trial (evolocumab): ↓ CV events by 15%",
      "ODYSSEY Outcomes (alirocumab): ↓ mortality after ACS",
      "ADR: Injection site reactions, myalgia, neurocognitive effects (rare)",
      "Safe in CKD & diabetes; extremely expensive (limitation)"
    ])
  ], { x: rightX + 0.05, y: 2.47, w: 4.55, h: 1.75 });

  // Inclisiran callout box
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.45, w: 9.5, h: 0.75, fill: { color: "FFF3CD" }, line: { color: AMBER, pt: 1.5 } });
  slide.addText([
    { text: "INCLISIRAN (siRNA) — Newest PCSK9 Approach: ", options: { bold: true, color: AMBER, fontSize: 12, fontFace: "Calibri" } },
    { text: "A small interfering RNA (siRNA) given SC every 6 months. It silences PCSK9 mRNA in hepatocytes (gene silencing). ↓ LDL-C ~50%. FDA approved 2021. Longer dosing interval improves compliance.", options: { color: GRAY, fontSize: 12, fontFace: "Calibri" } }
  ], { x: 0.35, y: 4.47, w: 9.3, h: 0.7 });

  addFooter(slide, 5);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 6 — BEMPEDOIC ACID & OTHER NEWER AGENTS
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Newer Agents: Bempedoic Acid, Lomitapide & Evinacumab", "Non-statin options for refractory dyslipidaemia");

  // Bempedoic acid
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.55, h: 0.32, fill: { color: "C0392B" } });
  slide.addText("BEMPEDOIC ACID (ACL Inhibitor — Nexletol)", { x: 0.3, y: 1.1, w: 4.4, h: 0.32, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Inhibits ATP-Citrate Lyase (ACL) — upstream of HMG-CoA reductase in cholesterol synthesis pathway",
      "Active only in liver (prodrug activated by ACSVL1) — NOT activated in muscle → no myopathy",
      "↓ LDL-C by ~17–25% (used with statins or alone)",
      "Oral once-daily dosing",
      "FDA approved 2020 for primary hyperlipidaemia & statin intolerance",
      "ADR: Hyperuricaemia/gout, tendon rupture (rare), elevated uric acid",
      "CLEAR Outcomes trial (2023): ↓ major CV events in statin-intolerant patients"
    ])
  ], { x: 0.3, y: 1.45, w: 4.5, h: 2.5 });

  // Lomitapide
  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.65, h: 0.32, fill: { color: "884EA0" } });
  slide.addText("LOMITAPIDE (MTP Inhibitor)", { x: 5.15, y: 1.1, w: 4.5, h: 0.32, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Inhibits Microsomal Triglyceride Transfer Protein (MTP) in hepatocytes & enterocytes",
      "↓ VLDL assembly and secretion → ↓ LDL",
      "↓ LDL-C by ~40–50%",
      "Indication: Homozygous Familial Hypercholesterolaemia (HoFH) only",
      "ADR: Hepatic steatosis (monitor LFTs), severe GI side effects — diarrhoea, nausea",
    ]),
    { text: "\n" },
    { text: "EVINACUMAB (Anti-ANGPTL3 mAb)", options: { bold: true, color: "884EA0", fontSize: 12, fontFace: "Calibri", breakLine: true } },
    ...subBulletItems([
      "Inhibits ANGPTL3 → activates LPL & EL → ↓ VLDL, TG, LDL",
      "IV infusion every 4 weeks; for HoFH",
      "↓ LDL-C ~50%; works even in LDL-R negative patients"
    ])
  ], { x: 5.15, y: 1.45, w: 4.5, h: 2.6 });

  // Mipomersen (historic note)
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.45, w: 9.5, h: 0.72, fill: { color: LBLUE2 }, line: { color: TEAL, pt: 1.2 } });
  slide.addText([
    { text: "MIPOMERSEN (Antisense oligonucleotide): ", options: { bold: true, color: TEAL, fontSize: 12, fontFace: "Calibri" } },
    { text: "Binds apoB-100 mRNA → prevents translation → ↓ VLDL/LDL production. Subcutaneous weekly; approved for HoFH. ADR: injection site reactions, flu-like symptoms, hepatic steatosis.", options: { color: GRAY, fontSize: 12, fontFace: "Calibri" } }
  ], { x: 0.35, y: 4.47, w: 9.3, h: 0.68 });

  addFooter(slide, 6);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 7 — FIBRATES & NIACIN
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Fibrates & Niacin — Triglyceride-Lowering Drugs", "Primarily used for hypertriglyceridaemia");

  // Fibrates
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.55, h: 0.32, fill: { color: "1A5276" } });
  slide.addText("FIBRATES (PPAR-α Agonists)", { x: 0.3, y: 1.1, w: 4.4, h: 0.32, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Drugs: Gemfibrozil, Fenofibrate, Bezafibrate, Ciprofibrate",
      "Mechanism: Activate PPAR-α → ↑ Lipoprotein Lipase (LPL) activity → ↑ VLDL clearance + ↑ FA oxidation → ↓ TG 40–60%, ↓ LDL 10–20%, ↑ HDL 10–20%",
      "Therapeutic use: Hypertriglyceridaemia, mixed dyslipidaemia, type IIb, III, IV, V familial hyperlipidaemia",
      "ADR: Myopathy (↑↑ if combined with statins — avoid Gemfibrozil + statin), cholelithiasis (↑ cholesterol excretion in bile), GI disturbances",
      "Pharmacokinetics: Highly protein-bound; potentiates warfarin (protein displacement)"
    ])
  ], { x: 0.3, y: 1.45, w: 4.5, h: 2.4 });

  // Niacin
  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.65, h: 0.32, fill: { color: "6E2F8B" } });
  slide.addText("NIACIN (Nicotinic Acid — Vitamin B3)", { x: 5.15, y: 1.1, w: 4.5, h: 0.32, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Mechanism: Inhibits adipose tissue lipolysis (via GPR109A receptor) → ↓ FFA flux to liver → ↓ VLDL & TG synthesis, ↑ HDL (by ↓ HDL catabolism)",
      "Effects: ↓ TG 25–35%, ↓ LDL 10–20%, ↑ HDL 15–35% — BEST agent for ↑ HDL-C",
      "Indication: Combined hyperlipidaemia; NOT indicated for ASCVD prevention (failed in trials)",
      "ADR: Cutaneous flushing (prostaglandin-mediated — give aspirin 30 min before), pruritus, hepatotoxicity, hyperuricaemia/gout, hyperglycaemia, peptic ulcer",
      "CI: Active liver disease, peptic ulcer, diabetes (relative), pregnancy"
    ])
  ], { x: 5.15, y: 1.45, w: 4.5, h: 2.6 });

  // Comparison table
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.05, w: 9.5, h: 0.28, fill: { color: NAVY } });
  ["Drug Class", "TG", "LDL", "HDL"].forEach((h, i) => {
    const xs = [0.3, 3.0, 5.5, 7.5];
    slide.addText(h, { x: xs[i], y: 4.05, w: 2.3, h: 0.28, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  });
  [["Fibrates", "↓ 40–60%", "↓ 10–20%", "↑ 10–20%"], ["Niacin", "↓ 25–35%", "↓ 10–20%", "↑ 15–35%"]].forEach(([cls, tg, ldl, hdl], i) => {
    const y = 4.35 + i * 0.3;
    const fill = i % 2 === 0 ? LBLUE2 : WHITE;
    [cls, tg, ldl, hdl].forEach((val, j) => {
      const xs = [0.3, 3.0, 5.5, 7.5];
      slide.addShape(pres.ShapeType.rect, { x: xs[j] - 0.05, y, w: 2.3, h: 0.28, fill: { color: fill } });
      slide.addText(val, { x: xs[j], y: y + 0.02, w: 2.2, h: 0.25, fontSize: 11, color: GRAY, fontFace: "Calibri" });
    });
  });

  addFooter(slide, 7);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 8 — OMEGA-3 FATTY ACIDS & COMBINATION THERAPY
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Omega-3 Fatty Acids & Combination Drug Therapy", "Adjunct therapy for residual cardiovascular risk");

  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.55, h: 0.32, fill: { color: TEAL } });
  slide.addText("OMEGA-3 FATTY ACIDS", { x: 0.3, y: 1.1, w: 4.4, h: 0.32, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "EPA (eicosapentaenoic acid) & DHA (docosahexaenoic acid) from marine sources",
      "Mechanism: Inhibit VLDL synthesis in liver → ↓ TG by 25–30%",
      "Icosapent ethyl (Vascepa): EPA-only; ↑ LDL-C avoided",
      "REDUCE-IT trial: Icosapent ethyl 4g/day → ↓ CV events by 25% in high-risk patients on statin",
      "Indication: Severe hypertriglyceridaemia (≥500 mg/dL) as adjunct",
      "ADR: Fishy taste, GI disturbance, ↑ bleeding risk (with anticoagulants)"
    ])
  ], { x: 0.3, y: 1.45, w: 4.5, h: 2.1 });

  slide.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.1, w: 4.65, h: 0.32, fill: { color: "C0392B" } });
  slide.addText("COMBINATION THERAPY PRINCIPLES", { x: 5.15, y: 1.1, w: 4.5, h: 0.32, fontSize: 11.5, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  slide.addText([
    ...bulletItems([
      "Step 1: Lifestyle modification (diet, exercise, weight loss) — ALWAYS first",
      "Step 2: High-intensity statin therapy (Atorvastatin 40–80mg or Rosuvastatin 20–40mg)",
      "Step 3: Add Ezetimibe 10mg if LDL-C goal not achieved",
      "Step 4: Add PCSK9 inhibitor (Alirocumab/Evolocumab) for very high-risk patients or familial HC",
      "For hypertriglyceridaemia: Add Fibrate or Icosapent ethyl",
      "AVOID: Statin + Gemfibrozil (↑ myopathy risk)"
    ])
  ], { x: 5.15, y: 1.45, w: 4.5, h: 2.2 });

  // Table: combination rules
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 3.75, w: 9.5, h: 0.28, fill: { color: AMBER } });
  slide.addText("Common Combinations — Additive LDL Lowering", { x: 0.35, y: 3.75, w: 9.3, h: 0.28, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  const combos = [
    ["Statin alone", "~40–50%", "First-line"], ["Statin + Ezetimibe", "~55–65%", "Before PCSK9"],
    ["Statin + PCSK9 inhibitor", "~70–80%", "High risk / FH"], ["Statin + Ezetimibe + PCSK9i", "~80–85%", "Refractory HoFH"]
  ];
  combos.forEach(([combo, ldrx, note], i) => {
    const y = 4.05 + i * 0.28;
    const fill = i % 2 === 0 ? LBLUE2 : WHITE;
    slide.addShape(pres.ShapeType.rect, { x: 0.25, y, w: 9.5, h: 0.27, fill: { color: fill } });
    slide.addText(combo, { x: 0.35, y: y + 0.03, w: 4.2, h: 0.22, fontSize: 11, color: GRAY, fontFace: "Calibri" });
    slide.addText(ldrx, { x: 4.6, y: y + 0.03, w: 2.0, h: 0.22, fontSize: 11, color: "C0392B", bold: true, fontFace: "Calibri" });
    slide.addText(note, { x: 6.65, y: y + 0.03, w: 3.0, h: 0.22, fontSize: 11, color: "5A6E80", fontFace: "Calibri" });
  });

  addFooter(slide, 8);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 9 — TREATMENT GUIDELINES & RISK STRATIFICATION
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Treatment Guidelines & Risk Stratification", "ACC/AHA 2019 & ESC/EAS 2019 recommendations");

  // Risk categories
  const risks = [
    { cat: "VERY HIGH RISK", ldl: "<55 mg/dL", color: "C0392B", who: "ASCVD (post-MI, stroke, PAD), FH + risk factor, DM + organ damage, eGFR <30" },
    { cat: "HIGH RISK", ldl: "<70 mg/dL", color: AMBER, who: "FH without risk factors, DM without organ damage, moderate CKD, 10-yr risk ≥10%" },
    { cat: "MODERATE RISK", ldl: "<100 mg/dL", color: TEAL, who: "10-yr ASCVD risk 5–10%; 3 or more risk factors" },
    { cat: "LOW RISK", ldl: "<116 mg/dL", color: "1E8449", who: "10-yr ASCVD risk <5%" },
  ];

  risks.forEach(({ cat, ldl, color, who }, i) => {
    const y = 1.1 + i * 1.0;
    slide.addShape(pres.ShapeType.rect, { x: 0.25, y, w: 2.2, h: 0.88, fill: { color }, line: { color } });
    slide.addText(cat, { x: 0.3, y: y + 0.05, w: 2.1, h: 0.4, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", align: "center" });
    slide.addText("LDL Goal:", { x: 0.3, y: y + 0.44, w: 2.1, h: 0.18, fontSize: 10, color: WHITE, fontFace: "Calibri", align: "center" });
    slide.addText(ldl, { x: 0.3, y: y + 0.62, w: 2.1, h: 0.22, fontSize: 13, bold: true, color: WHITE, fontFace: "Calibri", align: "center" });
    slide.addShape(pres.ShapeType.rect, { x: 2.48, y, w: 7.3, h: 0.88, fill: { color: LBLUE2 } });
    slide.addText(who, { x: 2.6, y: y + 0.15, w: 7.1, h: 0.65, fontSize: 12, color: GRAY, fontFace: "Calibri", valign: "middle" });
  });

  // 4 benefit groups note
  slide.addShape(pres.ShapeType.rect, { x: 0.25, y: 5.1, w: 9.5, h: 0.2, fill: { color: NAVY } });
  slide.addText("ACC/AHA 4 Statin Benefit Groups: (1) ASCVD, (2) LDL ≥190 mg/dL, (3) DM age 40–75 with LDL 70–189, (4) Primary prevention with 10-yr risk ≥7.5%",
    { x: 0.3, y: 5.1, w: 9.3, h: 0.2, fontSize: 9, color: WHITE, fontFace: "Calibri", valign: "middle" });

  addFooter(slide, 9);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 10 — COMPARISON TABLE (All Drug Classes)
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Comparative Summary of Hypolipidemic Drugs", "Quick reference for examinations");

  const headers = ["Drug Class", "↓ LDL", "↓ TG", "↑ HDL", "Key ADR"];
  const hWidths = [2.2, 1.3, 1.1, 1.1, 3.95];
  const startX = 0.2;
  const hxs = hWidths.reduce((acc, w, i) => { acc.push(i === 0 ? startX : acc[i-1] + hWidths[i-1]); return acc; }, []);

  // Header
  slide.addShape(pres.ShapeType.rect, { x: startX, y: 1.08, w: 9.6, h: 0.3, fill: { color: NAVY } });
  headers.forEach((h, i) => {
    slide.addText(h, { x: hxs[i] + 0.05, y: 1.08, w: hWidths[i] - 0.1, h: 0.3, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle" });
  });

  const rows = [
    ["Statins", "30–60%", "↓ 20–30%", "↑ 5–10%", "Myopathy, hepatotoxicity, teratogenic"],
    ["Ezetimibe", "18–20%", "↓ 5–8%", "↑ minor", "GI upset; safe in pregnancy"],
    ["PCSK9 Inhibitors*", "55–65%", "↓ 20–30%", "↑ 5–8%", "Injection site rxn; very expensive"],
    ["Bempedoic Acid*", "17–25%", "↓ 8–10%", "minimal", "Gout/hyperuricaemia, tendon rupture"],
    ["Bile Acid Resins", "15–30%", "↑ (may raise!)", "↑ minor", "Constipation, drug interactions"],
    ["Fibrates", "10–20%", "↓ 40–60%", "↑ 10–20%", "Myopathy (↑ w/ statins), gallstones"],
    ["Niacin", "10–20%", "↓ 25–35%", "↑ 15–35%", "Flushing, gout, hepatotoxicity"],
    ["Omega-3 (EPA/DHA)*", "minimal", "↓ 25–35%", "↑ minor", "GI, fishy taste, bleeding risk"],
    ["Lomitapide*", "~50%", "↓ 35%", "minimal", "Hepatic steatosis, severe GI (HoFH only)"],
  ];

  rows.forEach((row, i) => {
    const y = 1.4 + i * 0.38;
    const fill = i % 2 === 0 ? LBLUE2 : WHITE;
    slide.addShape(pres.ShapeType.rect, { x: startX, y, w: 9.6, h: 0.37, fill: { color: fill } });
    row.forEach((cell, j) => {
      const isNew = cell.endsWith("*") || row[0].includes("*");
      slide.addText(cell, {
        x: hxs[j] + 0.05, y: y + 0.04, w: hWidths[j] - 0.1, h: 0.3,
        fontSize: 10.5, color: j === 0 && isNew ? AMBER : GRAY,
        bold: j === 0, fontFace: "Calibri"
      });
    });
  });

  slide.addText("* Newer drug classes", { x: 0.25, y: 5.3, w: 4.0, h: 0.2, fontSize: 9, color: AMBER, italic: true, fontFace: "Calibri" });
  addFooter(slide, 10);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 11 — SPECIAL POPULATIONS & CLINICAL PEARLS
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: WHITE } });
  addSlideHeader(slide, "Special Populations & Important Clinical Points", "High-yield exam and clinical practice pearls");

  const pearls = [
    { title: "Pregnancy", body: "ALL statins CONTRAINDICATED (teratogenic — Category X). Use Bile acid sequestrants or Omega-3 FAs cautiously. Ezetimibe: avoid if possible.", color: "C0392B" },
    { title: "Statin Intolerance", body: "Try: alternative statin (Rosuvastatin) → Ezetimibe → Bempedoic acid → PCSK9 inhibitor. Bempedoic acid is particularly useful as it lacks muscle toxicity.", color: AMBER },
    { title: "CKD Patients", body: "Statins generally safe; Fibrates require dose adjustment or avoided in severe CKD; Ezetimibe safe; PCSK9 inhibitors safe in CKD.", color: TEAL },
    { title: "Diabetes & Dyslipidaemia", body: "Statins are first-line. Fibrates if hypertriglyceridaemia dominates. Niacin relatively contraindicated (worsens glucose control). Colesevelam has additional glycaemic benefit.", color: "1E8449" },
    { title: "Familial Hypercholesterolaemia", body: "HeFH: High-intensity statin + Ezetimibe + PCSK9i. HoFH: Add Lomitapide, Evinacumab, or LDL apheresis. Early diagnosis and treatment critical.", color: "7D3C98" },
    { title: "Myopathy Risk", body: "Risk ↑ with: statins + gemfibrozil, statins + macrolides/azole antifungals/cyclosporine (CYP3A4 inhibitors), hypothyroidism. Check CK if myalgia present.", color: NAVY },
  ];

  const cols = [0.25, 5.0];
  pearls.forEach(({ title, body, color }, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = cols[col];
    const y = 1.12 + row * 1.35;
    const w = 4.6;
    slide.addShape(pres.ShapeType.rect, { x, y, w, h: 1.3, fill: { color: LBLUE2 }, line: { color, pt: 2 } });
    slide.addShape(pres.ShapeType.rect, { x, y, w, h: 0.3, fill: { color } });
    slide.addText(title, { x: x + 0.08, y: y + 0.03, w: w - 0.15, h: 0.25, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri" });
    slide.addText(body, { x: x + 0.08, y: y + 0.33, w: w - 0.15, h: 0.92, fontSize: 10.5, color: GRAY, fontFace: "Calibri", valign: "top" });
  });

  addFooter(slide, 11);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 12 — SUMMARY & KEY TAKEAWAYS
// ══════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color: NAVY } });
  // Decorative shapes
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: 0.8, fill: { color: "0A1F40" } });
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0.8, w: "100%", h: 0.07, fill: { color: AMBER } });
  slide.addShape(pres.ShapeType.ellipse, { x: 8.5, y: 3.8, w: 2.0, h: 2.0, fill: { color: "0A2040" }, line: { color: "0A2040" } });

  slide.addText("KEY TAKEAWAYS", {
    x: 0.4, y: 0.08, w: 9.2, h: 0.65, fontSize: 30, bold: true, color: WHITE,
    fontFace: "Calibri", align: "center", charSpacing: 4
  });

  const points = [
    "Statins are FIRST-LINE for all patients with elevated LDL-C or ASCVD risk — ↓ LDL by 30–60%",
    "Ezetimibe is the go-to ADD-ON to statins (IMPROVE-IT trial); ↓ LDL by additional 20%",
    "PCSK9 Inhibitors (Alirocumab, Evolocumab) are most potent LDL-lowering agents; used for FH & high-risk ASCVD",
    "Inclisiran — novel siRNA therapy targeting PCSK9 mRNA; every 6-month SC injection",
    "Bempedoic acid — ACL inhibitor; statin-intolerant patients; no muscle toxicity",
    "Fibrates are preferred for ISOLATED hypertriglyceridaemia; AVOID with Gemfibrozil + statins",
    "Niacin — best ↑ HDL agent but NOT proven to reduce CV events; flushing is main complaint",
    "Treatment target: LDL-C <55 mg/dL (very high risk), <70 mg/dL (high risk)",
    "Statins are TERATOGENIC (Category X) — always avoid in pregnancy; use bile acid sequestrants"
  ];

  points.forEach((pt, i) => {
    slide.addText([
      { text: `${i + 1}. `, options: { bold: true, color: AMBER, fontSize: 13, fontFace: "Calibri" } },
      { text: pt, options: { color: WHITE, fontSize: 12.5, fontFace: "Calibri" } }
    ], { x: 0.4, y: 0.98 + i * 0.46, w: 9.1, h: 0.42 });
  });

  slide.addText("Lippincott Pharmacology 8e  |  Goodman & Gilman's 14e  |  ACC/AHA 2019 Cholesterol Guidelines",
    { x: 0.3, y: 5.35, w: 9.4, h: 0.22, fontSize: 9, color: "607D8B", fontFace: "Calibri", align: "center", italic: true });
}

// ─── WRITE FILE ──────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/hypolipidemic-ppt/Hypolipidemic_Drugs_MBBS2Prof.pptx" })
  .then(() => console.log("PPT created successfully!"))
  .catch(err => console.error("Error:", err));